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U.M.D.N.J. - Robert Wood Johnson Medical School
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H.I.P.H.O.P. Presents the 10th Annual 5K Fun
Run/Walk

All proceeds from this fundraiser will be donated
to St. Johns Family Health Center, Promise
Clinic, and community outreach sites that are
committed to care for the needs of the
underserved.



Date Saturday, April 18, 2009

Organized by UMDNJ/RWJMS-Homeless and Indigent
Population Health Outreach Project (H.I.P.H.O.P.)

Time 1000 am
1000 am

Registration 830 am

Where Johnson Park, Piscataway, NJ
Rain or Shine, No Rescheduling Date

• Entry fees
• 15.00 for registration
• 12.00 for students
• Team Rate 10 per person for teams of 7 or
  more who register before 4/1/09

First 200 people to register receive a T-shirt
Starting Point East of Landing Laneacross from
petting zoo (look for signs)

Certified 5K Course
For more information Call H.I.P.H.O.P.
Office [phone] Email
maniamra_at_umdnj.edu or susan.giordano_at_umdnj.edu








WAIVER I, the undersigned, know that running is
a potentially hazardous activity. I should not
enter unless I am medically able. I agree to
abide by any decision of a race official relative
to my ability to safely complete the race. I
assume all risks associated with running in this
event, including but not limited to falls,
contact with other runners, the effects of the
weather, including high heat and humidity,
traffic and the conditions of the course, all
such risks being known and appreciated by me.
Having read this waiver and knowing these facts,
and in consideration of my entry, I for myself
and anyone entitled to act on my behalf, waive
and release UMDNJ, the township of Piscataway,
and all of their liabilities of any kind arising
out of my participation in this event even though
liability may arise out of negligence or
carelessness arising on the part of the persons
named in this waiver.





Phone
Name


City, State, Zip
Address


Where did you hear about this event? Email
T-shirt Size
Age on race day
Gender M / F



Team Name

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Mail form and entry fee to H.I.P.H.O.P.

Attn Susan Giordano/Office of
Community Health
UMDNJ-Robert Wood Johnson
Medical School 675 Hoes
Lane, Room N-116, Piscataway, NJ 08854 Make
checks payable to UMDNJ-H.I.P.H.O.P.
Signature of participant
Date
Signature of parent / guardian (if under 18
years of age) Date